Which prescription would be considered contraindicated for Sam?

The prescription of administering 0.9% sodium chloride at 125 mL/hour would be considered contraindicated for Sam potentially due to the underlying health issue that requires careful management of fluids and electrolytes. For patients with conditions such as congestive heart failure, renal impairment, or if they are experiencing fluid overload, administering sodium chloride can exacerbate these issues by leading to increased fluid retention and worsening electrolyte imbalances.

Fluid replacement via a saline solution may not be appropriate in cases where the patient is struggling to manage fluid balance or has restrictions based on their health status. In such scenarios, initiating too much saline can lead to complications like hypertension, edema, or heart failure exacerbation, making it a choice that needs to be avoided in Sam's treatment plan.

The other options may be more appropriate to consider depending on Sam's overall health status and specific medical condition. For instance, tapering prednisone is often necessary when a patient has been on corticosteroids for a long time to reduce the risk of adrenal crisis, and administering analgesics can help manage any pain without negatively impacting fluid balance. Fluid restriction may be an appropriate measure, particularly in patients who require careful management of their intake to improve their condition.